Provider Demographics
NPI:1457663007
Name:ELSTER SARACHEK, SUSIE ESTHER (PT)
Entity Type:Individual
Prefix:
First Name:SUSIE
Middle Name:ESTHER
Last Name:ELSTER SARACHEK
Suffix:
Gender:F
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11920 DOROTHY ST
Mailing Address - Street 2:#206
Mailing Address - City:LOS ANGELES
Mailing Address - State:CA
Mailing Address - Zip Code:90049-5349
Mailing Address - Country:US
Mailing Address - Phone:310-560-7374
Mailing Address - Fax:
Practice Address - Street 1:116 W 23RD ST
Practice Address - Street 2:FIFTH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-2599
Practice Address - Country:US
Practice Address - Phone:646-375-2390
Practice Address - Fax:888-807-7794
Is Sole Proprietor?:Yes
Enumeration Date:2010-07-12
Last Update Date:2010-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPT16110225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist